Provider Demographics
NPI:1356001762
Name:CRISER, TONYA M
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:M
Last Name:CRISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 HAINES BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:SISSONVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25320-7187
Mailing Address - Country:US
Mailing Address - Phone:740-215-0443
Mailing Address - Fax:
Practice Address - Street 1:907 HAINES BRANCH RD
Practice Address - Street 2:
Practice Address - City:SISSONVILLE
Practice Address - State:WV
Practice Address - Zip Code:25320-7187
Practice Address - Country:US
Practice Address - Phone:740-215-0443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant